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Pittsburgh Sleep Quality Index (PSQI)
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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Pittsburgh Sleep Quality Index (PSQI)
1
How often have you had trouble sleeping because you cannot get to sleep within 30 minutes?
Select the option that best describes your situation.
Not during the past month
Less than once a week
Once or twice a week
Three or more times a week
2
Rate your sleep quality over the past month
Rate your sleep quality on a scale of 1 to 10, with 1 being poor and 10 being excellent.
3
During the past month, how often have you taken medicine to help you sleep?
Answer with a simple 'yes' or 'no'.
Yes
No
4
How satisfied/dissatisfied are you with your current sleep patterns?
Choose the option that best reflects your feelings.
Very satisfied
Fairly satisfied
Fairly dissatisfied
Very dissatisfied
5
How often have you had trouble staying awake while driving, eating meals, or engaging in social activity over the past month?
Select the frequency that matches your experience.
Not during the past month
Less than once a week
Once or twice a week
Three or more times a week
6
During the past month, how often have you had trouble remembering what happened during the day or week because of your sleep problems?
Select the frequency that best describes your experience.
Not at all
Less than once a week
Once or twice a week
Three or more times a week
7
How often have you had trouble sleeping because you wake up in the middle of the night or early morning?
Select the option that best describes your situation.
Not during the past month
Less than once a week
Once or twice a week
Three or more times a week
8
How often have you had trouble sleeping because you need to get up to use the bathroom?
Select the option that best describes your situation.
Not during the past month
Less than once a week
Once or twice a week
Three or more times a week
9
Overall, how would you rate your sleep quality over the past month?
Answer based on your overall impression.
Very good
Fairly good
Fairly bad
Very bad
10
In the past month, how often have you had trouble sleeping because of coughing or snoring loudly?
Select the frequency that best matches your experience.
Not during the past month
Less than once a week
Once or twice a week
Three or more times a week
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